Here Come Those Seasonal Allergies

(Part 1 of 3)

It’s hard to believe that fall is almost here. School starts today where I live, and evenings are getting cool (thank goodness). And with the fall comes another bout of seasonal allergies for those who are sensitive. (Though really, any season is allergy season. While most people think of blooming flowers and trees in the spring and ragweed in the fall as the worst culprits when it comes to allergens, we’re always surrounded by things that can make us sneeze, itch and, wheeze. Dust, mold, pet dander, and tobacco smoke know no season. )

Watery eyes, runny nose, and sneezing are the body’s way of trying to get rid of whatever is bothering you at the moment. Together, these symptoms are called allergic rhinitis (that’s hay fever to you and me), and they’re a gold mine for the medical industry. The top-selling prescription drug for nasal allergies, Nasonex, brought in more than a billion dollars in 2013 for its manufacturer.

But for most people, drugs are not the best solution. Depending on their category, prescription drugs either provide symptom relief or interfere with the function of your immune system. Whichever kind you use, the benefits are overwhelmed by the adverse effects.

Many people turn to over-the-counter medications for relief. Older antihistamines, such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton), are infamous for their adverse effects—especially drowsiness, but also rapid heartbeat, dry mouth, and problems emptying the bladder.

The second-generation antihistamines, including cetirizine (Zyrtec) and loratadine (Claritin), are less likely to have negative side effects, but users still report dry mouth, headache, and occasional rapid heartbeat. The newest antihistamines available aren’t really new at all; they’re just modifications of older drugs. While there does seem to be a slightly smaller risk of side effects, the drugs aren’t any more effective than their older brothers.

What’s Going On Inside

The human body is set up to reject unfamiliar invaders. Your immune system is constantly on the alert for bacteria and viruses that can cause infection if left unchallenged. A well-tuned immune system will know the difference between non-threatening newcomers and true stranger danger. But if something goes awry, in either genes or experience, your immune system goes after harmless substances such as dust and pollen.

The first time your immune system encounters something new, it creates specific antibodies that then attach themselves to specialized cells known as mast cells. When the newcomer shows up again, the mast cells release histamine—the chemical that causes the classic allergy symptoms.

Most drugs for allergy relief, including all the ones available over the counter, address the receptors for histamine—meaning that your immune response is still going haywire but the desired result, getting rid of the offenders, is blocked. A smaller class of drugs works to stabilize mast cells, so they don’t release so much histamine. Drugs in a third class disrupt the immune response entirely. Almost all of the drugs in this group are steroids, and are prescription-only.

That’s the background on allergies. Over the next couple days I’ll give you the rundown on allergy treatments that work—and ones that don’t.